Fatalities Due to Failure of Continuous Subcutaneous Insulin Infusion Devices: A Report of Six Cases.

Autor: Ziegler A; Boston University School of Medicine, Department of Anatomy & Neurobiology, Program of Biomedical Forensic Sciences, 72 E Concord Street, Boston, MA, 02118., Williams T; King County Medical Examiner's Office, 908 Jefferson Street, Seattle, WA, 98104., Yarid N; Erie County Medical Examiner, 501 Kensington Avenue, Buffalo, NY, 14214., Schultz DL; District 12 Medical Examiner Office, 2001 Siesta Drive #302, Sarasota, FL, 34231., Bundock EA; Office of the Chief Medical Examiner, 111 Colchester Ave # 1, Burlington, VT, 05401.
Jazyk: angličtina
Zdroj: Journal of forensic sciences [J Forensic Sci] 2019 Jan; Vol. 64 (1), pp. 275-280. Date of Electronic Publication: 2018 Jun 25.
DOI: 10.1111/1556-4029.13841
Abstrakt: Diabetes mellitus type 1 and type 2 are diseases characterized by impaired regulation of blood glucose due to decreased insulin production and insulin resistance, respectively. Management of diabetes mellitus often requires injection of exogenous insulin. Continuous subcutaneous insulin infusion (CSII or insulin pump) is a diabetes treatment modality utilizing a device to aid in regulation of glycemic control. Malfunctions in device components can have rare fatal consequences. Described in this report are six fatalities due to one such malfunction, the failure of plastic cannulas of CSII devices to penetrate the skin and deliver insulin, resulting in fatal diabetic ketoacidosis (DKA). The cases derive from four different death investigation systems. For each case, scene and autopsy findings are presented, as well as selected toxicology and histology findings. These cases illustrate the importance of careful examination of CSII devices in death investigations and introduce a discussion on discrepant manner of death classifications.
(© 2018 American Academy of Forensic Sciences.)
Databáze: MEDLINE
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